Positive Psychology Intervention to Treat Diabetes Distress in Teens with T1D

项目摘要 1型糖尿病（T1 D）青少年难以达到治疗目标-只有17%的青少年达到了治疗目标。 在最近的一项全国性研究中，许多青少年经历了高水平的糖尿病困扰， 与糖尿病护理的日常需求有关。然而，以前的干预措施，以改善血糖控制， 青少年1型糖尿病只显示出中度至中度的影响，许多人已经时间- 密集且昂贵。因此，需要新的干预措施来改善青少年的结果， T1D增加积极的影响，或与环境的愉快接触（例如，感到快乐，高兴， 自豪），已被证明可以促进使用更适应性的应对策略来管理压力。因此 一项拟议的研究是基于这样一个前提，即通过提高青少年糖尿病患者的积极影响，我们将 加强适应性应对策略的使用，减少糖尿病痛苦，从而改善血糖 控制青少年。通过一系列反复的试点研究，我们的研究团队采用了一种行为 使用积极心理学框架进行干预，我们证明这是可行和可接受的， 青少年T1 D这种干预的目的是通过以下方式在青少年（13-17岁）中产生积极的影响： 经过验证的，量身定制的感恩练习，自我肯定和照顾者肯定。在我们的试播集里 研究表明，干预措施对青少年的生活质量、糖尿病相关压力和 家庭冲突，所有这些都与糖尿病困扰密切相关。我们现在计划评估 多中心随机对照试验中的干预。本研究的目的是：1）评估 对青少年（13-17岁）及其照顾者进行积极的血糖控制心理干预; 2） 评估干预对糖尿病患者的苦恼、应对和自我护理行为的影响; 3）探讨 干预效应对人口统计学和治疗变量的不同影响。我们计划随机 200名积极情感+教育干预（n=100）或仅教育的受试者-护理者二人组 干预（n=100）从两个临床站点（范德比尔特大学医学中心和儿童国家 医疗中心）。通过采用积极心理学框架，我们提出了一种创新的方法来治疗 糖尿病困扰和改善血糖结果。我们相信这种新颖的干预有可能 改善青少年T1 D患者的预后，并使用自动短信传递 干预为广泛传播提供了可能性。

PROJECT SUMMARY Adolescents with type 1 diabetes (T1D) struggle to meet treatment goals – only 17% met the target for glycemic control in a recent national study – and many adolescents experience high levels of diabetes distress related to the daily demands of diabetes care. Yet, previous interventions to improve glycemic control in adolescents with type 1 diabetes have only shown modest to moderate effects, and many have been time- intensive and expensive. Thus, there is a need for novel interventions to improve outcomes in adolescents with T1D. Increasing positive affect, or pleasurable engagement with the environment (e.g., feeling happy, cheerful, proud), has been shown to promote the use of more adaptive coping strategies to manage stress. Thus, the proposed study is based on the premise that, by boosting positive affect in teens with diabetes, we will enhance the use of adaptive coping strategies and reduce diabetes distress, thereby improving glycemic control in adolescents. Through an iterative series of pilot studies, our research team adapted a behavioral intervention using a positive psychology framework that we demonstrated to be feasible and acceptable for adolescents with T1D. This intervention is aimed at inducing positive affect in adolescents (age 13-17) through empirically-validated, tailored exercises in gratitude, self-affirmation, and caregiver affirmations. In our pilot studies, the intervention had promising effects on adolescents' quality of life, diabetes-related stress, and family conflict, all of which are closely linked with diabetes distress. We now plan to evaluate the efficacy of the intervention in a multisite, randomized controlled trial. The aims of this study are to 1) evaluate the effects of a positive psychology intervention for adolescents (age 13-17) and their caregivers on glycemic control; 2) evaluate the effects of the intervention on diabetes distress, coping, and self-care behavior; and 3) explore the differential impact of intervention effects across demographic and treatment variables. We plan to randomize 200 adolescent-caregiver dyads to the Positive Affect + Education intervention (n=100) or the Education only intervention (n=100) from two clinical sites (Vanderbilt University Medical Center and Children's National Medical Center). By employing a positive psychology framework, we propose an innovative approach to treat diabetes distress and improve glycemic outcomes. We believe this novel intervention has the potential to improve outcomes in adolescents with T1D, and the use of automated text messaging to deliver the intervention offers possibilities for wide dissemination.